Provider Demographics
NPI:1598245177
Name:RUBALCABA, LAURISA YVETTE (SLPA)
Entity Type:Individual
Prefix:
First Name:LAURISA
Middle Name:YVETTE
Last Name:RUBALCABA
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2622 PRESIDIO DR APT 2
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-3325
Mailing Address - Country:US
Mailing Address - Phone:956-784-2077
Mailing Address - Fax:956-587-0245
Practice Address - Street 1:2622 PRESIDIO DR APT 2
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3325
Practice Address - Country:US
Practice Address - Phone:956-784-2077
Practice Address - Fax:956-587-0245
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX346682355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant